Suffering Through Success: Characteristics of High Functioning Anxiety

September 5, 2021

Anxiety appears in different ways for different people. Social anxiety is the fear of big crowds and small talk. Specific phobias might appear after a bad flight or an up-close encounter with a larger-than-life spider. High functioning anxiety is yet another type of anxiety, but one which often goes undiagnosed or misdiagnosed.

What is high functioning anxiety? Although this type of anxiety isn’t an official diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), many counselors and psychologists use it within their practice. It’s more of a symptom descriptor than an established diagnosis.

High functioning anxiety is a challenging type of anxiety to diagnose because the symptoms are counterintuitive. Many people with high functioning anxiety seem like the epitome of success. But underneath their productive exterior, they are in a constant state of chronic stress.

What is High Functioning Anxiety?

High angle view of businessman using smart phone amidst crowd.

As an unofficial subset of the traditional types of anxiety (general anxiety disorder, social anxiety disorder, and panic disorder), there is little to no peer-reviewed literature on the subject of high functioning anxiety.

Yet, even without scientific support for this diagnosis, it’s frequently used to describe highly-successful people who battle anxiety. Without a textbook definition of this type of anxiety, we rely on the common usage of the term.

In a news report on the subject, a journalist explained it as, “a high functioning person with anxiety who often doesn’t have any problems doing their job or socializing with others.”

The Huffington Post described high functioning anxiety as “when you may feel distressed, yet you continue to operate in your day-to-day life, meaning no one around you really knows what’s happening with you internally.”

Insider spoke with Cherlyn Chong, a relationship coach, who explained high functioning “refers to people who think they are functioning well, but really bottle everything up inside until it boils over.”

The team at Bridges to Recovery wrote that with people who have high functioning anxiety, “Their anxiety is real, significant, and unpleasant, but their behavior and accomplishments still seem to fall well within the range of normal.”

High Functioning Anxiety is Operating at Peak Stress, All the Time

Let’s imagine your mental health as an empty glass, waiting to be filled. As you move through your day, and through life, it’s filled with various emotions and mental states. On a bad day, stressful situations pour into your cup until it’s full. You can hardly take on any more as you head home from the office. But, at home, you unwind using your tool-kit of anxiety-reducing techniques and your glass empties again. It feels good.

Now imagine that your glass of mental health is always full. It’s continually hovering just below the rim, threatening to boil over. Any additional stressors would force it to spill, so you hustle hard to keep everything working smoothly, to avoid all the bumps in the road that could knock the glass over.

Because you operate day-in and day-out in this stressed-out state, it feels normal. In fact, you likely don’t even know how completely maxed out you are until suddenly you are rocked, and everything spills out.

High functioning anxiety is operating at peak stress, and all the while feeling normal. You have adapted over the months or years to keep busy and stay productive as a way to ignore the feeling inside. Because people with high functioning anxiety are just that — high functioning — they don’t realize the state of their mental health until they break down.

You Might Have High Functioning Anxiety If…

  1. Your friends would describe you as ‘high strung.’
  2. You find it challenging to handle sudden changes.
  3. After you head home from the office, you keep working.
  4. Before getting out of bed in the morning, you are already checking your emails.
  5. You find it very difficult to turn your mind off to relax.
  6. You characterize yourself as productive and highly organized.
  7. Following a well-laid plan feels comfortable and safe.
  8. To your colleagues, you are a huge success and a rock star employee.
  9. You find it difficult to say no when someone asks for help, no matter how busy you are.
  10. Your house is always organized, tidy, and spotless.

5 Positive Signs of High Functioning Anxiety

Most high functioning anxiety symptoms seem incredibly positive if you look at them from the surface. The positive traits of this type of anxiety are likely much easier to identify than the negative ones because they are visible and extroverted.

Unfortunately, because many of the most visible parts of this type of anxiety are perceived as beneficial, you might not feel the need to seek professional help. After all, if you are successful in everything you do – what is there to fix? But, operating at peak stress all the time eats away at both your mental and physical health. There is also an argument to be made that highly anxious people, whether functional or not, are not truly happy.

That aside, some of the most visible and outwardly beneficial high functioning anxiety symptoms include the following:

  1. Extremely helpful, always offering help to others when needed.
  2. Highly successful in their career of choice
  3. Clean, tidy, and orderly
  4. Accomplished
  5. Immaculate in the way you dress

5 Negative Signs of High Functioning Anxiety

Among people with high functioning anxiety, the negative signs and symptoms are much more challenging to see. On the outside, everything looks normal and likely very successful. Yet, on the inside, there may be a storm brewing.

The negative symptoms of high functioning anxiety may only make themselves known following a mental break down, panic attack, or another significant event. Without the help of a counselor, you might not even notice the anxious ticks and internal signs of stress.

Do you identify with any of these negative symptoms of high functioning anxiety?

  1. Racing mind, especially late at night
  2. Quick to assume the worst, and to fall into a negative thought spiral
  3. Feels impossible to live in the moment
  4. High risk for addiction to alcohol or drugs
  5. Difficulty facing change

High Functioning Anxiety Treatment Options

Young frustrated man solving his mental problems while having therapy session with psychologist

At its core, high functioning anxiety is just a subset of anxiety. Although it’s not a mental health condition supported by the DSM-5, high functioning anxiety falls under the umbrella of other anxiety disorders. The symptoms might look much different than the conventional description, but underneath the anxiety is precisely the same.

As with other types of anxiety, high functioning anxiety treatment will vary depending on the person. Standard treatments for anxiety include medications, talk therapy, or often a combination of the two. No two people are the same, and no two approaches to treatment will be either.

High functioning anxiety might rear its ugly head under a specific (and official) category of anxiety, like social anxiety disorder, general anxiety disorder, or panic disorder. If so, this might direct the treatment plan slightly to focus on those specific symptoms.

The best way to sort out a holistic plan for treating your anxiety, whatever it is, is with the assistance of a healthcare professional. Talk to a counselor about your experience. They can help direct you towards the best channels for treatment and provide you with skills to ease the anxiety when it peaks.

How to Overcome High Functioning Anxiety

In conjunction with assistance from a healthcare practitioner or certified counselor, is there anything you can do on your own for high functioning anxiety treatment?


Anxiety is challenging, no matter the symptoms. But the good news about anxiety is the ability to tackle it from a personal level. You can absolutely make changes to your life that will reduce the impact of anxiety and may, over time, eliminate it. So long as you are patient, practical, and kind to yourself, you will see slow and steady progress.

There are three stages to overcoming high functioning anxiety. Although they are technically a high functioning anxiety treatment, they are still a crucial aspect of your journey. You, counselor or doctor, may even help you create a plan of action.

Step 1: Acknowledgement You Are Anxious

Step back from the whirlwind of productivity and reflect on your wellbeing. Are you happy? Are you busy because you can’t sit still? Do you have nervous ticks? The hardest part of overcoming high functioning anxiety is recognizing the signs.

Again, they are often seen as beneficial, but if you take the time to analyze them with a keen eye, you might find they are clear indications you are always operating under a high level of stress.

Once you come to acknowledge how anxious you are, you’ll begin to see the effects across all areas of your life. The way you act in relationships, the difficulty you have sleeping, and even the reactions you have to problems at work – these may all feel the effects of your highly-strung personality.

Clarity on the signs and impacts of high functioning anxiety will allow you the space to work through them.

Step 2: Speak with Someone

It is possible to address anxiety alone, but it’s also incredibly powerful to have someone on your team. It’s much easier to have someone to talk to, who can guide you towards solutions than to stumble around on your own.

Therapists have years of experience working with people with the exact symptoms as you. They can help you work through underlying issues leading to the anxieties, and provide you with helpful tools to keep future worries at bay.

Step 3: Lifestyle Changes

Reducing anxiety in your day-to-day life is the number one way to overcome high functioning anxiety. There are hundreds of ways to reduce stress, including getting outside, meditation, and mindfulness. A few options particularly helpful for the high functioning person with anxiety: consider asking for help, delegating, and taking time out for yourself.

High Functioning Anxiety is Not Long Term Solution

No matter how useful you find the positive symptoms of high functioning anxiety, at the end of the day, they are detrimental to your mental and physical health. It is hard to thrive under the heavyweight of chronic stress, and it is impossible to be deeply happy.

Take time to assess the impact your anxiety is having on your health and wellness. How does it impact your relationships? Your happiness? Before your cup spills over, ask for help. Talk to a counselor.

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